Germany is one of the European countries that receive the highest number of refugees for the last years, with around 468 thousand asylum seekers in the first half of 2016. However, the increase in the speed of short-term procedures regarding refugees may at the same time overlook the risks regarding specific populations. Moreover, women and children constitute the most vulnerable groups during war and conflicts and the worst effects, in terms of physical, mental and social consequences, develop on these groups.

To understand deeply the psychosocial situation of female refugees that have arrived in Federal German Republic, to assess their challenges and resources before, during and after the displacement and to propose recommendations for policy changes.

The study consists of two modules, taking place in five states in Federal German Republic, including Berlin, Mecklenburg-Vorpommern, Bayern, Hessen und Mainz. In the first step, a representative stratified sample of female refugees from Syria, Iraq, Iran, Afghanistan, Somali and Eritrea are recruited. The quantitative study instrument include a socio-demographic question form and HSCL-Hopkins checklist, Harvard Trauma questionnaire, Beck depressions inventory, EUROHIS–QOL and SCL-14. In the second step, a qualitative in-depth analysis of focus group meetings is conducted.

There is an urgent need to take action for the mental health problems of refugees. This study constitutes one of the most extensive researches, especially on a subpopulation of refugees that requires specific attention. Challenges faced throughout the protocol and detailed results will be shared as presentation.

The authors have not supplied their declaration of competing interest.

Depression and anxiety are the main causes of psychiatric disorder in cancer patients, associated with a decreased tolerance and adherence to cancer treatment, longer hospital stays, decreased quality of life and possibly influence prognosis and mortality.

This review will address psychopharmacological options in cancer patients, side effects and possible drug interactions between psychotropic drugs and chemotherapy, either by toxicity, to which these patients are more sensitive, or a reduction in efficacy in anti-tumor treatment.

Non systematic literature review through the Medline and clinical key databases, with time constraints.

Selective Serotonin Reuptake Inhibitors are the first line treatment for depression, because of their tolerability and safety profile. Venlafaxine is the safer choice for the treatment of depression and hot flushes in women with breast cancer undergoing chemotherapy with tamoxifen. Tricyclic antidepressants are used in patients with neuropathic pain, due to its analgesic properties. Haloperidol is the safest antipsychotic, with less drug interactions and lower metabolic risk. Benzodiazepines are used in anxiety states for short periods. Psychostimulants are an option in patients with depression and life expectancy of less than one month. Mood stabilizers are recommended to treat mania, commonly induced by corticosteroids.

Treatment of psychiatric disease in cancer patients leads to an increased adherence to anti-tumoral treatment and improves quality of life. Regardless of the cancer stage there is indication to start treatment. We must, however, take into account possible side effects and drug interactions between psychotropic drugs and chemotherapy, through toxicity or diminished efficacy, when combined with anti-tumoral treatment.

The authors have not supplied their declaration of competing interest.

The number of long term cancer survivors (more than 5 years after diagnosis) are nowadays increasing because of advances in cancer screening, early detection, treatment strategies and management of acute treatment toxicities.

We aim to highlight the long-term psychological responses or late effect of cancer diagnosis and treatment.

Non systematic literature review through the Medline and clinical key databases, with time constraints.

There are physical and functional difficulties that may not be solved with the conclusion of treatment or can become problematic in survivors of cancer.

Long-term refers to psychological or emotional responses that emerge after cancer diagnosis and treatment and persist for at least 5 years. Late effects of cancer refer to psychological or emotional responses that emerge after treatment completion. Risk factors to its development depends on the diagnosis, type of treatment, age at treatment, time since treatment, genetic vulnerability, psychological, social and environmental factors.

Specific deficits are more prevalent in survivors than in healthy adults of the same age. Fatigue, sexual dysfunction, cognitive impairment and musculoskeletal symptoms are common. Functional limitations that induce restricted physical and social activities may happen in survivors. Physical function and late complications can be influenced by lifestyle, socio-economic and biologic factors.

Cancer survivors face short-term and long-term challenges to physical and mental health and they need to be addressed in the active treatment and throughout the continuum of survivorship care. Screening for mental health morbidity should be better integrated into active cancer treatment and survivorship and it should be provided mental health later interventions.

The authors have not supplied their declaration of competing interest.

Breast cancer significantly impacts dimensions of quality of life such as mental health, one's level of activity, family well-being, physical concerns (symptoms and pain), treatment satisfaction, emotional well-being, sexual intimacy, and social functioning.

The aim of this study is to evaluate the impact of the type of surgery on the quality of life of women being treated for breast cancer, based on the comparison of samples of women who have undergone different types of surgery.

Our sample consists of 90 Portuguese women divided into three groups of 30 participants each. The first group underwent radical surgery in order to treat their breast cancer. The second group of women had conservative surgery as a breast cancer treatment. Finally, the last group of women did not have any type of surgical intervention. We use a socio-demographic questionnaire and the Portuguese version of the EORTC QLQ-30 as measurement instruments. The sample consists of patients from a central hospital in Lisbon, Portugal, and the data were collected anonymously.

We find that in all dimensions of quality of life measured, including general health, physical functioning, social roles, and all emotional, cognitive, and social dimensions, the group of women who underwent radical surgery shows lower scores when compared to the other two groups. This indicates that this group has lower levels of quality of life.

The use of surgery for the treatment of breast cancer leads to a diminished quality of life following surgical intervention.

The authors have not supplied their declaration of competing interest.

Mindfulness based interventions (MBIs) have shown efficacy in improving psychological symptoms including depression and anxiety in cancer patients (pts). The study aimed to explore feasibility and reproducibility of MBIs in an Italian Cancer Centre measuring biochemical and psychological parameters.

In this pilot prospective case-control study, we recruited newly diagnosed pts receiving adjuvant chemotherapy (CT). A MBIs program was designed consisting of 2.5 hours weekly for 8 weeks and, including meditation, yoga and body scan. Material for 45 minutes (mn) home daily practice was provided. Primary endpoint was to evaluate feasibility. Secondary endpoints were assessment of quality of life (QoL), psychological and biochemical outcomes of stress, tested at baseline (W0), W4, W8, W24, W48. PSS (Perceived Stress Reduction), POMS (profile of mood states scores), EuroQoL (EQ-5D-3L) were administered.

Ten pts underwent MBIs program arm. We present preliminary results, while data of control arm are being collected. All pts were female, two pts (20%) dropped out. Median age was 56 years. All received adjuvant CT, 5/8 received radiotherapy and hormone therapy. Mean of sessions attending was 6.8 (76%). Median daily practice was 30 mn. EQ-5D item for depression and anxiety showed decreasing trend in mean score from moderate to light (P = 0.15) and significant improvement of auto-perceived QoL was observed comparing W0 and W8 (P = 0.02)

In a sensitive setting such as start CT, we found high pts compliance to MBIs. Improvement in self-perceived QoL after starting program was found and comparing anxious-depressive symptoms outcomes with control arm is still needed.

The authors have not supplied their declaration of competing interest.

The treatment of prostate cancer (PCa) can trigger a sequence of life-altering decisions that can induce depression and effects on health-related quality of life. We aimed to simultaneously compare all available psychosocial interventions using both direct and indirect data.

In this systematic review and network meta-analysis, we searched the Embase, Medline, PsycINFO, and the Cochrane central register of controlled trials for randomized controlled trials (RCT) published before Oct, 2016, that compared active treatments dealing with psychosocial problems in PCa patients after treatment. The primary outcome was health-related quality of life improvement as measured by the 36-Item Short-Form Health Survey (SF-36). Psychological morbidity was assessed with the Hospital Anxiety and Depression Scale (HADS). This study is registered with PROSPERO, number CRD42016049621.

We screened 113 potentially eligible studies and identified 31 RCTs, that examined 7 psychosocial interventions in 3643 PCa participants. In terms of SF-36, cognitive behavioral therapy [standard mean difference (SMD) 2·48, credible interval [CrI] 0.23 to 4.46], group based counseling (SMD 1·36, CrI 0·40 to 3·17) had significantly greater effects than usual care. Participants assigned to all assessed interventions had a significantly improvement in depression compared with usual care, except for those assigned to psychoeducational therapy (SMD 0.02, 95% CrI -0.11 to 0.15).

This review shows that cognitive behavioral therapy, group based counseling and exercise may have significant beneficial effects considering SF-36 and HADS when compared with usual care. However, additional well-done research studies are necessary to establish the role of psychosocial interventions in men with PCa.

The authors have not supplied their declaration of competing interest.

The association between suicide and cancer is complex. Hopelessness and depression are the common risk factors for both suicide and cancer. There is also evidence that suicide rate in cancer patients are higher than in the general population. However, the real occurrence of suicide in cancer patients is considered to be underreported. This is a good reason to expect a positive relationship between cancer mortality and suicide rates at the population level.

The present study aims to test the hypothesis of the close aggregate level link between cancer mortality and the suicide rates in Russia.

Trends in sex-specific cancer mortality and the suicide rates from 1956 to 2010 were analyzed employing a distributed lags analysis.

The results of analysis indicate the presence of a statistically significant association between trends in suicides and cancer of the upper digestive tract (mouth, oral cavity and pharynx), larynx, bronchus and lungs, stomach, colorectal, uretus and leukemia for male. There is also a statistically significant association between trends in suicides and cancer of the upper digestive tract (mouth, oral cavity and pharynx), larynx, bronchus and lungs, stomach, colorectal, uretus, breast, cervix, uterus and leukemia for female.

Common confounding variables, including binge drinking and psychosocial distress, may explain positive aggregate-level association between the cancer mortality and suicides time series in Russia.

The author has not supplied his/her declaration of competing interest.

Neurofeedback in migraine aims to improve neurophysiological state, which is linked to psychosomatic, emotional and cognitive regulation. Objective and complex evaluation of neurofeedback effects is feasible.

A single case design cross-over placebo-controlled study with blinded evaluator included 3 females with frequent migraine (N., E., T.), 1 of whom (T.) also had TTH. Study had 4 phases: evaluation (≥ 2 weeks), treatment 1 (5 weeks), treatment 2 (5 weeks), evaluation (≥ 2 weeks). Treatment 1 and 2 included 10 infra-low frequency neurofeedback and 10 sham-neurofeedback sessions at T3T4 site in randomized order. Detailed psychological assessment was performed a baseline, at phase switch and in the end. Every day participants filler a computerized diary about pain, aura, mood, stress, copings. Before each session they received questionnaires “well-being, activity, mood” (rating of the current state between antonym adjectives, in Russian).

The main finding was reduction of migraine (but not TTH) frequency during real, but not sham neurofeedback phase: 11% vs. 31% days in N. (P = 0.1), 15% vs. 30% days in E. (P = 0.046), T. After the start of neurofeedback had only TTH. Another detected phenomena was reduction of day-to-day shifts in cognitive function domains of “well-being, activity, mood” (easy/difficult to think, attentive/distracted). In N. and E these domains had co-dynamic with mood (good/bad mood, happy/sad), while in T. – with anxiety (tensed/relaxed, nervous/calm).

Infra-low frequency neurofeedback from interhemispheric site resulted in decrease in migraine frequency and in reduction of shifts in psychological state. Thus, the treatment had multimodal stabilizing effect.

The authors have not supplied their declaration of competing interest.

Sham-controlled studies of neurofeedback are aimed to provide evidence-based data regarding its efficacy. However, a sophisticated sham procedure may turn out to be an intervention rather that a neutral control.

Data from a single-case cross-over sham-controlled study of NF in migraine were analyzed to access the effects of sham-NF. The study included 5 females with chronic migraine and was divided into 4 phases: pre-evaluation (≥ 2 weeks), treatment 1 (5 weeks), treatment 2 (5 weeks), post-evaluation (≥ 2 weeks), where treatment 1 and 2 included 10 infra-low frequency NF and 10 sham-NF sessions at T3T4 site in randomized order. Participants filled out a computerized diary about headache and emotions.

Sham-NF resulted in some reduction of the level of tension (0.8 ± 0.7 vs. 1.1 ± 0.5, P = 0.1) and anxiety (0.56 ± 0.5 vs. 0.95 ± 0.4, P = 0.07) as measured by the mean value in the diary (rating from 0 - no emotion, to 3 - very intense). While the total frequency of headache was not influenced by sham-NF (40 ± 11% vs. 40 ± 7% days, P = 1), a tendency towards an increase in quantity of severe headaches (42 ± 18% vs. 20 ± 18% days, P = 0.07) and in the need for drug intake (74 ± 27% vs. 44 ± 30% days, P = 0.07) was observed. We supposed that expectation of feedback and failure to receive it during sham sessions may have possible negative effects, while frequent visits to the clinic and contact with the therapist may explain reduction in anxiety.

Sham-NF seems to have both placebo and nocebo effects, which should be considered during interpretation of results of the studies.

The authors have not supplied their declaration of competing interest.

Recent studies show a different mode of expression of pain associated with disorders of verbal and nonverbal communication, body schema and some cognitive impairment in autistic children.

The aim of our study was to evaluate the reactivity of an autistic child in a slightly painful stimulation in a standardized situation where there is a dual relationship with an adult.

We conducted a study, on 40 children with autism. The diagnosis of autism was established following a multidisciplinary assessment including scale ADIR (Autism Diagnostic Interview Revised) and ADOS (Autism Diagnostic Observation Schedule). Severity of autism was assessed by the CARS (Childhood Autism Rating Scale). All subjects were submitted to a pinch with a clothespin camouflaged by the palm of the hand of the examiner. The reactivity to pain was assessed by the NCCPC (Non-communicating children's pain checklist).

All children have responded to pain, 57.5% had moderate to severe pain and 42.5% had mild pain. The evaluation of the expression of pain according to the items of the NCCPC showed that 95% of children responded with motor responses, 90% responded with vocal productions, only half of the children (55%) presented facial expressions and 12. 5% of the children showed physiological indices. The analysis of the type of motor and vocal reactions was not moving toward pain in almost all children (removal or protection of the area of the body affected, the precise location of the painful area are almost absent in our sample).

These results are in favor of a different mode of expression of pain in children with autism.

The authors have not supplied their declaration of competing interest.

Maxillofacial surgeons and dentists often deal with the phenomenon of temporomandibular pain-dysfunction syndrome–painful condition of maxillofacial area without clear organic pathology. Psychiatric studies of this disorder are almost lacking. The aim of this study was to determine the prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and to define the psychiatric diagnosis (ICD-10).

Study sample consists of 57 patients (44 women and 13 men) with temporomandibular pain-dysfunction syndrome aged older than 18 years, who gave inform consent. The study used clinical psychopathological, psychometric (HADS, HDRS, State-Trait Anxiety Inventory, Hypochondria Whitley Index, Visual Analog Scale for Pain).

Psychiatric disorders were revealed in 48 patients (84.2%) with temporomandibular pain-dysfunction syndrome–39 women and 9 men aged 18-65 years (mean age 39.6 ± 15.4 years). Affective disorders was diagnosed in 56.3%, personality disorders in 20.8%, schizotypal personality disorder in 12.5% and schizophrenia in 10.4%. Among affective pathology mild and moderate depressive episodes prevailed (59.3%). The severity of pain (VAS) in patients with affective disorders was higher than in patients with other psychiatric conditions.

This study shows high prevalence of psychiatric disorders in patients with temporomandibular pain-dysfunction syndrome and proves the feasibility of a psychiatrist participate in the complex treatment of these patients. The use of psychometric method allows to improve the timeliness of the detection of patients who require further clinical psychopathological examination in order to determine the need of pharmacotherapy.

The authors have not supplied their declaration of competing interest.

Burning mouth syndrome (BMS) is characterized by an intraoral burning sensation for which no medical or dental cause can be found. Sporadic evidence suggests that drug induced conditions may evoke BMS. Intriguingly, we observed a patient who developed BMS after induction of citalopram.

A case report of patient with BMS from our psychiatric ward will be presented here, followed by a literature review on drugs induced BMS.

Based on a recent literature search, we present a first case report of BMS that was apparently induced in patient shortly after beginning of citalopram. We performed a systematic search through PubMed, EMBASE and Cochrane's Library to find more cases of psychotropic induced BMS.

Ms. A. was a 72-year old woman meeting DSM-IV diagnostic criteria for melancholic depression, who was observed in a clinical setting. We started citalopram 10 mg. 1dd1, with 10 mg. 1dd1 increase over 7 days to 20 mg, 1dd1. The following day, she displayed a persistent burning painful sensation in the mouth. Other than BMS oropharyngological syndromes were excluded after consultation with qualified medical specialists. Citalopram therapy was discontinued, and nortrilen treatment was initiated. BMS symptoms resolved over four days. Twelve case reports have linked BMS to the use antidepressants and anxiolytics.

Contrasting the statement that no medical cause can be found for BMS, we found that psychotropics may evoke the syndrome. Compared to other psychotropic drugs, antidepressant medication has the strongest association with BMS.

The authors have not supplied their declaration of competing interest.

The Oxford Happiness Inventory (OHI) 29-Item, each involving the selection of four options that are different for each item. Although there is an Arabic version, it is not identical to the original version in terms of the number of items and response.

to evaluate the psychometric properties of the Arabic adaptation OHI and its factorial structure in undergraduate sample.

The participants were 720 first year undergraduate Kuwaitis: 360 males mean age = 20.38 ± 1.60 and 360 females; mean age = 19.71 ± 1.39 (t = 5.87, P < 0.001). The Arabic version of OHI (Argyle, Martin, & Crossland) was administered to participants. The internal consistency reliability, factor structure, and convergent validity of the OHI with Life Orientation Test (LOT-R, Adult Hope Scale (AHS), Satisfaction With Life Scale (SWLS) were assessed as well as divergent validity of the OHI with Beck Depression Inventory-II (BDI-II)

Internal consistency was satisfactory for the OHI (Cronbach's alpha = 0.87) for males and (Cronbach's alpha = 0.86) for females. The results revealed no significant gender differences on happiness (F = 1.77, P > 05). Principal component analyses (PCA) showed that a seven-component solution explains %50.50 of the total variance for males and 51.47% for females. The OHI positively correlates with the following variables: SWLS (r = .52), LOT-R (r = 0.56) AHS (r = .48) while the OHI correlates negatively with BDI-II (r = -54).

Findings confirm that the OHI provides satisfactory validation, and thus it can be recommended as a measure of happiness among Arab samples.

The authors have not supplied their declaration of competing interest.

Perfectionist Self Presentation represents the interpersonal expression of perfectionism wherein individuals engage in strategies that promote their supposed perfection and conceal their perceived imperfections (Hewitt et al., 2003).

To investigate the psychometric properties of the Portuguese version of the Perfectionist Self Presentation Scale/PSPS.

Two hundred and eighty-six university students (69.2% females; mean age = 21.09 ± 2.133) answered the Portuguese preliminary version of the PSPS, and the Portuguese validated versions of: Multidimensional Perfectionism Scales, Dirty Dozen and Depression Anxiety and Stress Scale. To study the temporal stability, 30 participants (66.7% females) answered the PSPS again after six weeks. SPSS and MPlus were used.

The PSPS Cronbach alpha was .91. The test-retest correlation coefficient was .66 (P < .01). Exploratory factor analysis resulted in a three dimension's model (χ2 = 1974.015, P < .01; RMSEA = 0.079, 90% CI = 0.069–0.088; CFI = 0.869; TLI = 0.812; SRMR = 0.046). The three factors presented good internal consistency: F1 Perfectionist self-presentation (PSPS; a = .85), F2 Interpersonal Concern over mistakes (ICM; a = .79); F3 Perfectionist image (PI; a = .70).

PSP and ICM (and PI with fewer significant coefficients and lower magnitudes) were moderately to highly correlate with personal standards, concern over mistakes, doubts about action, self-oriented perfectionism and social prescribed perfectionism (≥ .40). Correlations with narcissism and machiavellianism, anxiety and stress were moderate (r = .30) (all P < .01).

The Portuguese version of PSPS has good reliability and validity, with the factorial model presenting an acceptable fit (Hair et al., 2004). It could be very useful both in clinical and research contexts, namely in an ongoing research project on the relationship between perfectionism and interpersonal functioning.

The authors have not supplied their declaration of competing interest.

The Five-Factor Model organizes human personality traits under a comprehensive framework of five dimensions–neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. The dimensions are empirical generalizations of enduring differences in behavioural, emotional and cognitive patterns between individuals. The Portuguese version of the NEO-Five Factor Inventory (NEO-FFI-20) is increasingly used as it is the shortest version to evaluate the “Big 5”.

To investigate the reliability and the validity of the Portuguese version of NEO-FFI-20-item (Bertoquini & Pais Ribeiro) in a Portuguese sample, using exploratory and confirmatory factor analysis (EFA and CFA).

747 participants [417 (55.8%) women; mean age = 42.13 ± 12.349 years] answered an online survey which included the NEO-FFI-20 and socio-demographic questions. The total sample was randomly divided in two sub-samples (sample A, n = 373; sample B, n = 374). Sample A was used to EFA and sample B was used to CFA.

The Portuguese version of NEO-FFI-20, excluding items 14 and 16, had an acceptable fit to the data (χ2/df = 2.28; TLI = .88; CFI = .90; RMSEA = .06; P = .059). The internal consistency analysis resulted in: Neuroticism, α = .68; Extraversion, α = .62; Openness to Experience, α = .74; Agreeableness, α = .70; and Conscientiousness, α = .74.

The NEO-FFI-20 can be used to reliably and validly evaluate the BIG FIVE in an ongoing research project on traffic psychology to better understand and respond to risky behaviours on the road.

The authors have not supplied their declaration of competing interest.

According to contemporary phenomenological literature, dysphoria is the background mood characterizing patients with borderline personality disorders (BPD). In particular circumstances, it can take the form of a state of pressure, urge to act, and quasi-explosion, which is very dependent on situational triggers. There are currently no instruments able to measure this situational form of dysphoria.

To develop and analyze psychometric properties of the Situational Dysphoria Scale (SITDS), a self-report questionnaire that measures situational dysphoria.

To validate the SITDS for a future use in routine clinical practice and, more generally, to assess different forms of dysphoria in BPD in a more precise way.

The preliminary 58-item SITDS was administered to 105 BPD patients, along with other conceptually similar (Nepean Dysphoria Scale) and conceptually distinct (Cynical Distrust Scale, Inventory of Interpersonal Problems-47, empathy quotient, and borderline personality severity Index-IV) instruments. The psychometric characteristics (reliability, internal structure, convergent and divergent validity) of the SITDS were then examined.

The final 24-item SITDS (with each item rated on three subscales: internal pressure, urge to act, and quasi-explosion) demonstrated excellent internal consistency (alpha = .91). A three-cluster solution was found, with clusters pertaining to personal events, interpersonal events, and environmental events. There were medium to strong correlations with NDS, and weaker but still significant correlations with CynDis, IIP-47, EQ, and BPDSI-IV.

The SITDS is a useful and easy-to-handle instrument for measuring situational dysphoria. Further research in clinical samples is needed.

The authors have not supplied their declaration of competing interest.

The purpose of the study was to review prescribing guidelines and clinical practices for EUPD.

MEDLINE and PsycINFO were searched for all English-language articles published 2000-2016 and containing the keywords “emotionally unstable personality disorder”, “borderline personality disorder”, “pharmacotherapy”, “drug treatment” and “treatment guidelines”.

NICE guidelines (2009) recommend pharmacotherapy should not be used for EUPD but for comorbid conditions only. In line with the American Psychiatric Association practice guideline, the Dutch and German guidelines recommend antipsychotics for cognitive-perceptual symptoms. However, in contrary to mood stabilisers they question the efficacy of antidepressants on impulsivity and affective dysregulation.

Studies on clinical practice showed 68% of borderline patients without comorbid disorder in UK were using antidepressants, 59% antipsychotics, 59% sedatives and 23% mood stabilizers. Similar results reported Paolini et al with polypharmacy in 83.5% of cases.

All international guidelines recommend psychological therapies as the first-choice in EUPD treatment but diverge with respect to pharmacotherapy use. NICE and Australian guidelines abstain from psychotropics what may prevent to some degree counterproductive polypharmacy, but also can refrain from temporary pharmacological support when needed. More RCTs for pharmacotherapy use in EUPD are needed but meanwhile using pharmacotherapeutic algorithms for specific symptom domains might be the way forward.

The author has not supplied his/her declaration of competing interest.

As more or less stable personality traits of the person, temperament, intellect and body is what makes an individual unique compatibility with the environment.

The purpose of this research was standardizing the questionnaire of personality disorder cluster A. On the basis of realizing criterion standard, DSM- 5.

1303 people from universities of Tehran and Alborz provinces (753 females and 550 males) were examined by using the randomized sampling method. The questions of the questionnaire were conformed Dr. ShahramVaziri on the basis of Iran s population and culture. Then the reliability was tested and accomplished simultaneously Millon(MCMI-III) questionnaire.

After computing the correlation scales of Millon test with each of the questions, 20 questions that showed the highest correlation and diagnosis coefficient were chosen and scored again in next stage.

Investigating the psychometric component of three scales (Paranoid 60%, Schizoid 66%, Schizotypal 59%) shows that they are reliable and defensibly valid. It can be said that questions related to all three measures paranoid, schizoid and schizotypal of acceptable psychometric properties and reliability are desirable.

The authors have not supplied their declaration of competing interest.

Narcissistic personality disorder influences relationships and beliefs in different life spheres.

We aimed to measure narcissism among Bulgarian adults by establishing validity of two scales measuring narcissism, specifying some social and demographic factors and differentiating narcissistic features.

One hundred and thirty-four Bulgarians (17–62 years old, M = 31; SD = 11) were examined with two scales measuring narcissism. Higher score on Narcissistic personality disorder scale from the Personality Diagnostic Questionnaire-4 correlated positively (r = .346; P < .001) with higher score on A. T. Beck and J. S. Beck's scale measuring Narcissistic beliefs from Personality Belief Questionnaire that indicated their validity.

No significant gender differences in narcissism were found, with female participants prevailing in the sample (n = 118). Family status (FPDQ−4(4,128) = 0.593; pPDQ-4 = 569; FPBQ(4,128) = 0.295; pPBQ = .881), occupational status – student, employed or unemployed (FPDQ−4(4,128) = 0.593; pPDQ−4 = .569; FPBQ(4,128) = 0.295; pPBQ = .881), secondary or university education (tPDQ−4(112) = 1.809; pPDQ−4 = .073; tPBQ(112) = 1.338; pPBQ = .184), and the length of work experience did not differentiate narcissism (RPDQ−4 = .168; tPDQ−4 = −1.853; pPDQ−4 = .066; RPBQ = .063; tPBQ = −0.681; pPBQ = .497). Advance in age was related to diminished levels of narcissism (RPDQ−4 = .21; R2PDQ−4 = .044; BPDQ−4 = −0.034; tPDQ−4 = −2.463; pPDQ−4 = .015). Higher narcissism was related to the belief of being a special person (70.8%) and to the perceptions of other people as being envy of one's personality–own achievements (60.9%).

Narcissistic personality disorder is rare in the studied Bulgarian adult population – 4.5% of the subjects (n = 6) had the highest levels of narcissism on both scales that corresponded to the proportion of 6% prevalence of lifetime narcissism in USA, according to Stinson et al.

The authors have not supplied their declaration of competing interest.

H&F Multidimensional Perfectionism Scale is a widely used measure of perfectionism developed to measure Self-oriented perfectionism (SOP), Socially-prescribed perfectionism (SPP) and Other-oriented perfectionism (OOP) dimensions. The original scale comprises 45-likert items. We have previously developed a short version of The H&F-MPS, with 13 items, showing adequate validity in a sample of university students, using principal component analyses method with factors varimax rotation.

To examine the factor structure of the H&F-MPS13 with confirmatory factor analysis (CFA), using a different sample of Portuguese university students.

The sample comprises 245 university students (68.9% females), with a mean age of 20.95 years (SD= 2.19; range= 17–33) who completed the H&F-MPS13. CFA was used to test the model suggested by prior exploratory factor analyses of H&F-MPS13.

After correlated errors, we obtained a good fit for the second-order factor (X2/d= 2.577; CFI= 0.928; GFI= 0.915, RMSEA= 0.080; P[rmsea ≤ 0.05] = 0.001). The H&F-MPS13 showed acceptable internal consistency (α= 0.77) and the three dimensions presented Cronbach's alphas ranging between acceptable and good (α OOP = 0.67; SPP = 0.73; SOP = 0.89).

The H&F-MPS13 obtained through CFA is a reliable and valid measure to assess perfectionism in Portuguese university students.

The authors have not supplied their declaration of competing interest.